글루코코르티코이드

동물 종별 용량

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

• Systemic fungal infections (unless used for physiologic replacement)
• Intramuscular administration in patients with idiopathic thrombocytopenia
• Known hypersensitivity to the specific compound
• Chronic use of sustained-release injectables for systemic diseases
• Concurrent use with NSAIDs (relative contraindication due to severe GI ulcer risk)
• Pregnant animals
• Renal disease (systemic use)
• Diabetes mellitus (systemic use)
• Systemic fungal infections
• Corneal ulcers
• Concurrent use of NSAIDs
• Uncontrolled diabetes mellitus
• Late pregnancy (may induce abortion or parturition)

이상반응

• Polyuria (PU), polydipsia (PD), and polyphagia (PP)
• Weight gain and fat redistribution
• Panting (especially in dogs)
• Dull, dry haircoat and alopecia
• Vomiting and diarrhea
• Gastrointestinal ulceration
• Elevated liver enzymes (ALP > ALT) and vacuolar hepatopathy (dogs)
• Pancreatitis
• Insulin resistance leading to or worsening diabetes mellitus
• Muscle wasting and weakness
• Behavioral changes (depression, lethargy, viciousness)
• Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
• Laminitis (horses)
• Hypothalamic-pituitary axis (HPA) suppression
• Adrenal atrophy

약물 상호작용

• Amphotericin B · May cause hypokalemia when administered concomitantly
• Anticholinesterase agents (e.g., pyridostigmine) · May lead to profound muscle weakness in myasthenia gravis patients; discontinue 24h prior if possible
• Aspirin (salicylates) · Glucocorticoids may reduce salicylate blood levels; increased risk of GI ulceration
• Cyclophosphamide · Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
• Cyclosporine · May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
• Digoxin · Increased risk for arrhythmias secondary to glucocorticoid-induced hypokalemia
• Diuretics (potassium-depleting, e.g., furosemide) · May cause additive hypokalemia
• Ephedrine · May increase glucocorticoid metabolism
• Estrogens · May potentiate the effects of hydrocortisone and possibly other glucocorticoids
• Insulin · Insulin requirements may increase due to glucocorticoid-induced insulin resistance · moderate
• Ketoconazole · May decrease glucocorticoid metabolism
• Mitotane · May alter steroid metabolism; higher steroid doses may be necessary to treat mitotane-induced adrenal insufficiency

모니터링

• Weight, appetite, and signs of edema
• Serum and/or urine electrolytes (potassium, calcium, sodium)
• Total plasma proteins and albumin
• Blood glucose
• Liver enzymes (ALP, ALT, GGT)
• Growth and development in young animals
• ACTH stimulation test (if assessing adrenal recovery or iatrogenic Cushing's)
• Clinical signs of hyperadrenocorticism
• Blood glucose (especially in diabetics)
• Electrolytes (potassium)
• Thyroid panel (T3/T4 may decrease)
• Clinical signs of PU/PD and weight gain
• Blood glucose (due to diabetes mellitus risk)
• ACTH stimulation test (to monitor HPA axis suppression)
• Water intake and urine output

과용량

Short-term massive overdoses are unlikely to cause acute harmful effects, though one case of acute CNS effects in a dog has been reported (treat supportively). Chronic overdosage leads to serious adverse effects manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome).